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Please use this identifier to cite or link to this item: http://hdl.handle.net/1843/55180
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dc.creatorJúnia r o Lschweizerpt_BR
dc.creatorAntônio Ribeiro-oliveirapt_BR
dc.creatorMartin Bidlingmaierpt_BR
dc.creatorKatharina Schilbachpt_BR
dc.creatorMichael Haeneltpt_BR
dc.creatorAlexandre v Giannettipt_BR
dc.creatorMariana f Bizzipt_BR
dc.creatorBeatriz s Soarespt_BR
dc.creatorEduardo Paulino Júniorpt_BR
dc.creatorJochen Schopohlpt_BR
dc.creatorSylvère Störmannpt_BR
dc.date.accessioned2023-06-20T20:45:23Z-
dc.date.available2023-06-20T20:45:23Z-
dc.date.issued2021-
dc.citation.volume106pt_BR
dc.citation.issue8pt_BR
dc.citation.spagee2887pt_BR
dc.citation.epagee2899pt_BR
dc.identifier.doihttps://doi.org/10.1210/clinem/dgab257pt_BR
dc.identifier.issn0021972Xpt_BR
dc.identifier.urihttp://hdl.handle.net/1843/55180-
dc.description.resumoAbstract Context: Soluble alpha klotho (sαKL) has been linked to growth hormone (GH) action, but systematic evaluation and comparisons with traditional biomarkers in acromegaly are lacking.Objective: To evaluate the potential of sαKL to aid classification of disease activity. Methods: This retrospective study at 2 academic centers included acromegaly patients before surgery (A, n = 29); after surgery (controlled, discordant, or uncontrolled) without most discordant patients. A cutoff of 1548 pg/mL for sαKL discriminated controlled (B1, C1) and uncontrolled (B3, C3) patients with 97.8% (88.4%-99.9%) sensitivity and 100% (77.1%-100%) specificity. sαKL was below the cutoff in 84% of the discordant subjects. In the remaining 16%, elevated sαKL and IGF-I persisted, despite normal random GH. Sex, age, body mass index, and markers of bone and calcium metabolism did not significantly affect sαKL concentrations. Conclusion: Our data support sαKL as a biomarker to assess disease activity in acromegaly. sαKL exhibits close association with GH secretory status, large dynamic range, and robustness toward biological confounders. Its measurement could be helpful particularly when GH and IGF-I provide discrepant information (B1, B2, B3, n = 28, 11, 8); or with somatostatin analogue treatment (C1, C2, C3, n = 17, 11, 5); nonfunctioning pituitary adenomas (n = 20); and healthy controls (n = 31). sαKL was measured by immunoassay and compared with traditional biomarkers (random and nadir GH, insulin-like growth factor I [IGF-I], IGF binding protein 3). Associations with disease activity were assessed.Results: sαKL was correlated to traditional biomarkers, particularly IGF-I (rs =0.80, P <0.0001). High concentrations before treatment (A, median, interquartile range: 4.04 × upper limit of normal [2.26-8.08]) dropped to normal after treatment in controlled and in most discordant patients. A cutoff of 1548 pg/mL for sαKL discriminated controlled (B1, C1) and uncontrolled (B3, C3) patients with 97.8% (88.4%-99.9%) sensitivity and 100% (77.1%-100%) specificity. sαKL was below the cutoff in 84% of the discordant subjects. In the remaining 16%, elevated sαKL and IGF-I persisted, despite normal random GH. Sex, age, body mass index, and markers of bone and calcium metabolism did not significantly affect sαKL concentrations.Conclusion: Our data support sαKL as a biomarker to assess disease activity in acromegaly. sαKL exhibits close association with GH secretory status, large dynamic range, and robustness toward biological confounders. Its measurement could be helpful particularly when GH and IGF-I provide discrepant information.pt_BR
dc.format.mimetypepdfpt_BR
dc.languageengpt_BR
dc.publisherUniversidade Federal de Minas Geraispt_BR
dc.publisher.countryBrasilpt_BR
dc.publisher.departmentICB - DEPARTAMENTO DE MORFOLOGIApt_BR
dc.publisher.departmentMED - DEPARTAMENTO DE ANATOMIA PATOLÓGICA E MEDICINA LEGALpt_BR
dc.publisher.departmentMED - DEPARTAMENTO DE CIRURGIApt_BR
dc.publisher.departmentMED - DEPARTAMENTO DE CLÍNICA MÉDICApt_BR
dc.publisher.initialsUFMGpt_BR
dc.relation.ispartofThe Journal of Clinical Endocrinology & Metabolism-
dc.rightsAcesso Abertopt_BR
dc.subjectBiomarkerspt_BR
dc.subjectInsulin-like growth factorpt_BR
dc.subjectGrowth factor-binding protein 3pt_BR
dc.subjectInsulin-like growth factor-binding protein 3pt_BR
dc.subject.otherBiomarcadores Farmacológicospt_BR
dc.subject.otherProteína 3 de Ligação a Fator de Crescimento Semelhante à Insulinapt_BR
dc.subject.otherSomatomedinaspt_BR
dc.subject.otherFator de Crescimento Insulin-Like Ipt_BR
dc.titleSoluble Alpha Klotho in Acromegaly: comparison with traditional markers of disease activitypt_BR
dc.typeArtigo de Periódicopt_BR
dc.url.externahttps://academic.oup.com/jcem/article/106/8/e2887/6232405pt_BR
dc.identifier.orcidhttps://orcid.org/0000-0001-6157-6511pt_BR
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